Phenotyping in bronchiectasis: Are we moving toward a personalized medicine?
Paola Faverio1, Stefano Carlo Zucchetti1, Edoardo Simonetta1, Francesco Amati2, Andrea Gramegna2, Giovanni Sotgiu3, Francesco Blasi2, Anthony De Soyza4, Stefano Aliberti2
1 Department of Cardio-Thoracic-Vascular, University of Milan Bicocca, Respiratory Unit, ASST Monza, San Gerardo Hospital, Monza, Italy
2 Department of Pathophysiology and Transplantation, University of Milan, Cardio-Thoracic Unit and Cystic Fibrosis Adult Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
3 Department of Biomedical Sciences, Clinical Epidemiology and Medical Statistics Unit, University of Sassari, Sassari, Italy
4 Institute of Cellular Medicine, Newcastle University, and UK Bronchiectasis Service, Freeman Hospital, Newcastle Upon Tyne, UK
Prof. Stefano Aliberti
Department of Pathophysiology and Transplantation, Cystic Fibrosis Adult Center, University of Milan, Cardio-thoracic Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, Milan 20122
Source of Support: None, Conflict of Interest: None
Bronchiectasis (BE) is a heterogeneous disease. Similarly, to other chronic airway diseases, such as asthma and chronic obstructive pulmonary disease, management of BE patients requires a specific and personalized treatment that depends on many clinical, functional, and microbiological variables. Therefore, developing phenotyping methods that can help clinical and therapeutic choices is of paramount importance. Various methodological approaches have been used to personalize patients' management. In this review, we explore the main tools identified so far to classify and phenotype BE patients, including the approaches based on BE etiologies, disease severity, cluster analysis, and endotyping. We also discuss the strengths and limitations of every approach and highlight the similarities and differences between these studies. Finally, we review the therapeutic implications and clinical management connected with each approach.